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Case Reports
. 2019 Mar 26;7(6):805-808.
doi: 10.12998/wjcc.v7.i6.805.

Unexplained abdominal pain due to a fish bone penetrating the gastric antrum and migrating into the neck of the pancreas: A case report

Rui Xie  1 , Bi-Guang Tuo  1 , Hui-Chao Wu  2
Affiliations
Case Reports

Unexplained abdominal pain due to a fish bone penetrating the gastric antrum and migrating into the neck of the pancreas: A case report

Rui Xie et al. World J Clin Cases. .

Abstract

Background: Ingestion of foreign bodies results in gastrointestinal perforation in approximately 1% of patients, and fish bones are the objects that most commonly lead to bowel perforation. When it does occur, the terminal ileum is the most common site of perforation, followed by the duodenal C-loop. However, involvement of the pancreas is very rare. Because clinical symptoms are nonspecific and gastrointestinal perforation may present as only odynophagia or abdominal pain, a definite preoperative diagnosis and clinical intervention may be delayed.

Case summary: We report the case of a 32-year-old man who presented to our hospital because of abdominal pain that had worsened over 5 d. He had no significant past history except that he had eaten fish 1 wk previously. Upper endoscopy revealed an irregular submucosal tumor on the front wall of the gastric antrum. Endoscopic ultrasonography and computed tomography showed a fish bone penetrating the gastric antrum and migratingin to the neck of the pancreas. The patient underwent laparoscopic surgery and had no complications one week after the operation.

Conclusion: A recent history of foreign body ingestion and imaging examinations are helpful for diagnosis of unexplained abdominal pain caused by foreign bodies.

Keywords: Case report; Fish bone; Gastrointestinal perforation; Pancreas; Unexplained abdominal pain.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Images of the patient. A: Upper endoscopy revealed an irregular submucosal tumor on the front wall of the gastric antrum; B: Endoscopic ultrasonography showed abnormal and irregular thickening of the stomach wall and an approximately 3.5-cm linear and hyperechoic lesion protruding through the thickened stomach wall and the pancreatic body (arrow); C: Computed tomography image showing a thin, linear, hyperdense structure (arrow) along the stomach wall and pancreatic body; D: Photograph of the fish bone after removal.
See this image and copyright information in PMC

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